title: Physician roles in tactical emergency medical support: the first 20 years.
abstract: BACKGROUND
  The benefits of Tactical Emergency Medical Support (TEMS) elements are providing injury prevention, immediate care of injuries, and medical augmentation of the success of dangerous law enforcement operations. TEMS is recognized by civilian Special Weapons and Tactics (SWAT) and various other law enforcement agencies around the country as a vital addition to such SWAT teams. The integration of specially trained TEMS personnel has become a key component of law enforcement special operations.
  
  
  OBJECTIVE
  Our aim was to review the published literature to identify if there is a role for physicians within TEMS elements with regard to its establishment and progression, and to characterize the level of physician-specific support provided in the tactical environment for civilian tactical law enforcement teams.
  
  
  CONCLUSIONS
  Physician presence as part of TEMS elements is increasing in number and popularity as the realization of the benefits provided by such physicians has become more apparent. The inclusion of physicians as active and participating members of TEMS elements is a critical measure to be taken for tactical law enforcement units. Physicians provide an added level of medical expertise to TEMS elements in rural and urban settings compared with law enforcement personnel with medic training.
  
  
  CONCLUSIONS
  Physician involvement is an essential element of a successful TEMS program. There is a need for more physicians to become involved as TEMS personnel for specialized tactical teams to spread the time commitment and increase their availability to tactical units on a daily basis.
authors.affiliation: Department of Surgery, University of California, Davis Medical Center, Sacramento, California.
authors.forename: Jason B
authors.initials: JB
authors.lastname: Young
authors.affiliation: Department of Surgery, David Grant Medical Center, Travis Air Force Base, California.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Sena
authors.affiliation: Department of Surgery, University of California, Davis Medical Center, Sacramento, California.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Galante
mesh_terms: D004630:Emergencies; D004638:Emergency Treatment; D006801:Humans; D035846:Law Enforcement; D010819:Physician's Role; D014947:Wounds and Injuries / Q000628:therapy
keywords: SWAT; TEMS; law enforcement; tactical emergency medical support; tactical medics